da form 1 - development application details · 2020-03-06 · da form 1 - development application...

DA Form 1 - Development application detailsApproved form (version 1.1 effective 22 JUNE 2018) made under section 282 of the Planning Act 2016.

This form must be used to make a development application involving code assessment or impact assessment, except when applying for development involving building work.

For a development application involving building work only, use DA Form 2 - Building work details.

For a development application involving building work associated with any other type of assessable development (i.e. material change of use, operational work or reconfiguring a lot), use this form (DA Form 1) and parts 4 to 6 of DA Form 2 - Building work details.

Unless stated otherwise, all parts of this form must be completed in full and all required supporting information must accompany the development application.

One or more additional pages may be attached as a schedule to this development application if there is insufficient space on the form to include all the necessary information.

This form and any other form relevant to the development application must be used to make a development application relating to strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994, and airport land under the Airport Assets (Restructuring and Disposal) Act 2008. For the purpose of assessing a development application relating to strategic port land and Brisbane core port land, any reference to a planning scheme is taken to mean a land use plan for the strategic port land, Brisbane port land use plan for Brisbane core port land, or a land use plan for airport land.

Note: All terms used in this form have the meaning given under the Planning Act 2016, the Planning Regulation 2017, or the Development Assessment Rules (DA Rules).

PART 1 - APPLICANT DETAILS

1) Applicant detailsApplicant name(s) (individual or company full name)

Contact name (only applicable for companies)

Postal address (P.O. Box or street address) 31 o&hWB cZFFZzFrrSuburbStatePostcodeCountryContact number

1 1

Email address (non-mandatory) Wc?Fm<3vM -

Mobile number (non-mandatory)

Fax number (non-mandatory)» f j

Applicant’s reference number(s) (if applicable)

2) Owner’s consent2.1) Is written consent of the owner required for this development application?

O Yes - the written consent of the owner(s) is attached to this development application B No - proceed to 3)

QueenslandGovernment

PART 2 - LOCATION DETAILS

DA Form 1 - Development Application details

Version 1.1—22 JUNE 2018

□ Listed on the Environmental Management Register (EMR) under the Environmental Protection Act 1994EMR site identification:□ Listed on the Contaminated Land Register (CLR) under the Environmenta CLR site identification:

Protection Act 1994

5) Are there any existing easements over the premises?Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and how they may affect the proposed development, see DA Forms Guide.

□ Yes - All easement locations,, types and dimensions are included in plans submitted with this development application

SNo

PART 3 - DEVELOPMENT DETAILS

Section 1 - Aspects of development______



6.3) Additional aspects of development□ Additional aspects of development are relevant to this development application and the details for these aspects that would be required under Part 3 Section 1 of this form have been attached to this development application

Not required

Section 2 - Further development details7) Does the proposed development application involve any of the following?Material change of use □ Yes - complete division 1 if assessable against a local planning instrumentReconfiguring a lot □ Yes - complete division 2Operational work KT Yes - complete division 3Building work □ Yes - complete DA Form 2 - Building work details

Division 1 - Material change of useNote: This division is only required to be completed if any part of the development application involves a material change of use assessable against a local planning instrument.____________________________________________________________________________________________________

8.1) Describe the proposed material change of useProvide a general description of the proposed use

Provide the planning scheme definition(include each definition in a new row)

Number of dwelling units (if applicable)

Gross floor area (m2)(if applicable)

8.2) Does the proposed use involve the use of existing buildings on the premises?□ Yes□ No

Division 2 - Reconfiguring a lotNote: This division is only required to be completed if any part of the development application involves reconfiguring a lot.

9.1) What is the total number of existing lots making up the premises?

9.2) What is the nature of the lot reconfiguration? (tick all applicable boxes)

□ Subdivision (complete to)) □ Dividing land into parts by agreement (complete 11))

□ Boundary realignment (complete 12)) □ Creating or changing an easement giving access to a lot from a construction road (complete 13))

10) Subdivision10.1) For this development, how many lots are being created and what is the intended use of those lots:Intended use of lots created Residential Commercial Industrial Other, please specify:

Number of lots created10.2) Will the subdivision be staged?□ Yes - provide additional details below□ NoHow many stages will the works include?What stage(s) will this development application apply to?



11) Dividing land into parts by agreement - how many parts are being created and what is the intended use of the parts?Intended use of parts created

Number of parts created

Residential Commercial Industrial Other, please specify:

12) Boundary realignment12.1) What are the current and proposed areas for each lot comprising the premises?

Current lot Proposed lotLot on plan description Area (m2) Lot on plan description Area (m2)

r

12.2) What is the reason for the boundary realignment?

13) What are the dimensions and nature of any existing easements being changed and/or any proposed easement?(attach schedule if there are more than two easements)

Existing or proposed?

Width (m) Length (m) Purpose of the easement? (e.g. pedestrian access)

Identify the land/lot(s) benefitted by the easement

Division 3 - Operational workNote: This division is only required to be completed if any part of the development application involves operational work.

14.1) What is the nature of the operational work?□ Road work□ Drainage workK) Landscaping□ Other - please specify:

□ Stormwater □ Water infrastructure •□ Earthworks O Sewage infrastructure□ Signage SI Clearing vegetation

14.2) Is the operational work necessary to facilitate the creation of new lots? (e.g. subdivision)

G Yes - specify number of new lots:IS No14.3) What is the monetary value of the proposed operational work? (include gst, materials and labour)

I $ io, oco

PART 4 - ASSESSMENT MANAGER DETAILS

□ Yes - a copy of the decision notice is attached to this development application□ Local government is taken to have agreed to the superseded planning scheme request - relevant documents attached□ No



PART 5 - REFERRAL DETAILS

17) Do any aspects of the proposed development require referral for any referral requirements?Note: A development application will require referral if prescribed by the Planning Regulation 2017.

Kl No, there are no referral requirements relevant to any development aspects identified in this development application - proceed to Part 6Matters requiring referral to the Chief Executive of the Planning Regulation 2017:□ Clearing native vegetation□ Contaminated land (unexploded ordnance)I I Environmentally relevant activities (ERA) (only if the ERA have not been devolved to a local government)□ Fisheries - aquaculture□ Fisheries - declared fish habitat area□ Fisheries - marine plants□ Fisheries - waterway barrier works□ Flazardous chemical facilitiesI I Queensland heritage place (on or near a Queensland heritage place)□ Infrastructure - designated premises□ Infrastructure - state transport infrastructure□ Infrastructure - state transport corridors and future state transport corridors□ Infrastructure - state-controlled transport tunnels and future state-controlled transport tunnels□ Infrastructure - near a state-controlled road intersection□ On Brisbane core port land near a State transport corridor or future State transport corridor□ On Brisbane core port land - ERA□ On Brisbane core port land - tidal works or work in a coastal management district□ On Brisbane core port land - hazardous chemical facility□ On Brisbane core port land - taking or interfering with water□ On Brisbane core port land - referable dams□ On Brisbane core port land - fisheries□ Land within Port of Brisbane’s port limits□ SEQ development area□ SEQ regional landscape and rural production area or SEQ rural living area - tourist activity or sport and recreation activity□ SEQ regional landscape and rural production area or SEQ rural living area - community activity□ SEQ regional landscape and rural production area or SEQ rural living area - indoor recreation□ SEQ regional landscape and rural production area or SEQ rural living area - urban activity□ SEQ regional landscape and rural production area or SEQ rural living area - combined use□ Tidal works or works in a coastal management district□ Reconfiguring a lot in a coastal management district or for a canal□ Erosion prone area in a coastal management district□ Urban design□ Water-related development - taking or interfering with water□ Water-related development - removing quarry material (from a watercourse or lake)□ Water-related development - referable dams□ Water-related development - construction of new levees or modification of existing levees (category 3 levees only)□ Wetland protection areaMatters requiring referral to the local government:□ Airport landI I Environmentally relevant activities (ERA) (only if the ERA have been devolved to local government)□ Local heritage places



Matters requiring referral to the chief executive of the distribution entity or transmission entity:□ Electricity infrastructure

Matters requiring referral to:• The Chief executive of the holder of the licence, if not an individual• The holder of the licence, if the holder of the licence is an individual□ Oil and gas infrastructureMatters requiring referral to the Brisbane City Council:□ Brisbane core port landMatters requiring referral to the Minister under the Transport Infrastructure Act 1994:□ Brisbane core port land (inconsistent with Brisbane port LUP for transport reasons)D Strategic port landMatters requiring referral to the relevant port operator:□ Land within Port of Brisbane’s port limits (below high-water mark)

Matters requiring referral to the Chief Executive of the relevant port authority:□ Land within limits of another port (below high-water mark)

Matters requiring referral to the Gold Coast Waterways Authority:□ Tidal works, or work in a coastal management district in Gold Coast waters

Matters requiring referral to the Queensland Fire and Emergency Service:□ Tidal works marina (more than six vessel berths)

18) Has any referral agency provided a referral response for this development application?□ Yes - referral response(s) received and listed below are attached to this development application□ NoReferral requirement Referral agency Date of referral response

Identify and describe any changes made to the proposed development application that was the subject of the referral response and the development application the subject of this form, or include details in a schedule to this development application (if applicable).

PART 6 - INFORMATION REQUEST

19) Information request under Part 3 of the DA RulesEl I agree to receive an information request if determined necessary for this development application □ I do not agree to accept an information request for this development application Note: By not agreeing to accept an information request I, the applicant, acknowledge:• that this development application will be assessed and decided based on the information provided when making this development application

and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA Rules to accept any additional information provided by the applicant for the development application unless agreed to by the relevant parties

• Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.Further advice about information requests is contained in the DA Forms Guide.



PART 7 - FURTHER DETAILS

20) Are there any associated development applications or current approvals? (e.g. a preliminary approval)

□ Yes - provide details below or include details in a schedule to this development applicationE NoList of approval/development application references

Reference number Date Assessmentmanager

□ Approval□ Development application□ Approval□ Development application

21) Has the portable long service leave levy been paid? (only applicable to development applications involving building work or operational work)

□ Yes - a copy of the receipted QLeave form is attached to this development application□ No - I, the applicant will provide evidence that the portable long service leave levy has been paid before the assessment manager decides the development application. I acknowledge that the assessment manager may give a development approval only if I provide evidence that the portable long service leave levy has been paid[><{ Not applicable (e.g. building and construction work is less than $150,000 excluding GST)Amount paid Date paid (dd/mm/yy) QLeave levy number$

22) Is this development application in response to a show cause notice or required as a result of an enforcement notice?□ Yes - show cause or enforcement notice is attached El No

23) Further legislative requirementsEnvironmentally relevant activities23.1) Is this development application also taken to be an application for an environmental authority for an Environmentally Relevant Activity (ERA) under section 115 of the Environmental Protection Act 1994?

Clearing native vegetation



23.3) Does this development application involve clearing native vegetation that requires written confirmation that the chief executive of the Vegetation Management Act 1999 is satisfied the clearing is for a relevant purpose under section 22A of the Vegetation Management Act 1999?□ Yes - this development application includes written confirmation from the chief executive of the Vegetation Management Act 1999 (s22A determination)KlNoNote: 1. Where a development application for operational work or material change of use requires a s22A determination and this is not included, the development application is prohibited development.2. See httos://www. aid, gov. au/environment/land/veaetation/aDDlvina for further information on how to obtain a s22A determination.

Environmental offsets23.4) Is this development application taken to be a prescribed activity that may have a significant residual impact on a prescribed environmental matter under the Environmental Offsets Act 2014?□ Yes - I acknowledge that an environmental offset must be provided for any prescribed activity assessed as having a significant residual impact on a prescribed environmental matter E( NoNote: The environmental offset section of the Queensland Government’s website can be accessed at www.ald.aov.au for further information on environmental offsets.

Koala conservation23.5) Does this development application involve a material change of use, reconfiguring a lot or operational work within an assessable development area under Schedule 10, Part 10 of the Planning Regulation 2017?□ Yes

Note: See guidance materials at www. des. aid, aov.au for further information.

Water resources23.6) Does this development application involve taking or interfering with underground water through an artesian or subartesian bore, taking or interfering with water in a watercourse, lake or spring, or taking overland flow water under the Water Act 2000?

Marine activities23.8) Does this development application involve aquaculture, works within a declared fish habitat area or removal, disturbance or destruction of marine plants?□ Yes - an associated resource allocation authority is attached to this development application, if required underthe Fisheries Act 1994KNoNote: See guidance materials at www. daf. aid, aov. au for further information.

Quarry materials from a watercourse or lake23.9) Does this development application involve the removal of quarry materials from a watercourse or lake under the Water Act 2000?



http://www.ald.aov.au

□ Yes - I acknowledge that a quarry material allocation notice must be obtained prior to commencing development H NoNote: Contact the Department of Natural Resources, Mines and Energy at www. dnrme. aid, aov.au and www.business.ald.aov.au for further information.

Quarry materials from land under tidal waters

23.10) Does this development application involve the removal of quarry materials from land under tidal water under the Coastal Protection and Management Act 1995?□ Yes - I acknowledge that a quarry material allocation notice must be obtained prior to commencing development El NoNote: Contact the Department of Environment and Science at www.des.ald.aov.au for further information.

Referable dams23.11) Does this development application involve a referable dam required to be failure impact assessed under section 343 of the Water Supply (Safety and Reliability) Act 2008 (the Water Supply Act)?□ Yes - the ‘Notice Accepting a Failure Impact Assessment’ from the chief executive administering the Water Supply Act is attached to this development application El NoNote: See guidance materials at www.dnrme.ald.aov.au for further information.

Tidal work or development within a coastal manaaement district

23.12) Does this development application involve tidal work or development in a coastal management district?□ Yes - the following is included with this development application:

□ Evidence the proposal meets the code for assessable development that is prescribed tidal work (only required if application involves prescribed tidal work)□ A certificate of title

K[NoNote: See guidance materials at www.des.ald.aov.au for further information.

Queensland and local heritaqe places

23.13) Does this development application propose development on or adjoining a place entered in the Queensland heritage register or on a place entered in a local government's Local Heritage Register?□ Yes - details of the heritage place are provided in the table below K] NoNote: See guidance materials at www. des. aid, aov.au for information requirements regarding development of Queensland heritage places.

Name of the heritage place:

Brothels

Place ID:

23.14) Does this development application involve a material change of use for a brothel?□ Yes - this development application demonstrates how the proposal meets the code for a development application for a brothel under Schedule 3 of the Prostitution Regulation 2014 ES NoDecision under section 62 of the Transoort Infrastructure Act 1994

23.15) Does this development application involve new or changed access to a state-controlled road?□ Yes - this application will be taken to be an application for a decision under section 62 of the Transport Infrastructure Act 1994 (subject to the conditions in section 75 of the Transport Infrastructure Act 1994 being satisfied)SI No



http://www.business.ald.aov.au

http://www.des.ald.aov.au

http://www.dnrme.ald.aov.au

http://www.des.ald.aov.au

PART 8 - CHECKLIST AND APPLICANT DECLARATION

24) Development application checklistI have identified the assessment manager in question 15 and all relevant referral requirement(s) in question 17Note: See the Planning Regulation 2017 for referral requirements

□ Yes

If building work is associated with the proposed development, Parts 4 to 6 of DA Form 2 - Building work details have been completed and attached to this development application

□ YesH Not applicable

Supporting information addressing any applicable assessment benchmarks is with development applicationNote: This is a mandatory requirement and includes any relevant templates under question 23, a planning report and any technical reports required by the relevant categorising instruments (e.g. local government planning schemes, State Planning Policy, State Development Assessment Provisions). For further information, see DA Forms Guide: Plannina Report Template.

□ Yes

Relevant plans of the development are attached to this development applicationNote: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide: Relevant plans.

0 Yes

The portable long service leave levy for QLeave has been paid, or will be paid before a development permit is issued /see 21))

□ YesS Not applicable

25) Applicant declarationH By making this development application, I declare that all information in this development application is true and correctM Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications from the assessment manager and any referral agency for the development application where written information is required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001 Note: It is unlawful to intentionally provide false or misleading information.Privacy - Personal information collected in this form will be used by the assessment manager and/or chosen assessment manager, any relevant referral agency and/or building certifier (including any professional advisers which may be engaged by those entities) while processing, assessing and deciding the development application.All information relating to this development application may be available for inspection and purchase, and/or published on the assessment manager’s and/or referral agency’s website.Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation 2017 and the DA Rules except where:• such disclosure is in accordance with the provisions about public access to documents contained in the Planning

Act 2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and Planning Regulation 2017; or

• required by other legislation (including the Right to Information Act 2009)] or• otherwise required by law.This information may be stored in relevant databases. The information collected will be retained as required by the Public Records Act 2002.

PART 9 - FOR OFFICE USE ONLY

Date received: Reference number(s):

Notification of engagement of alternative assessment managerPrescribed assessment managerName of chosen assessment managerDate chosen assessment manager engagedContact number of chosen assessment manager



Relevant licence number(s) of chosen assessment manager

QLeave notification and paymentNote: For completion by assessment manager if applicable

Description of the workQLeave project numberAmount paid ($)Date paidDate receipted form sighted by assessment managerName of officer who sighted the form



da form 1 - development application details · 2020-03-06 · da form 1 - development application...

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